What Happens During a Typical TMS Session?
During a typical TMS session, a trained provider places a magnetic coil against the scalp, usually near the forehead. The device delivers focused magnetic pulses to specific brain regions involved in mood regulation. Each session lasts approximately 20 to 40 minutes. Patients remain awake and seated comfortably throughout the procedure. No anesthesia is needed, and most people return to their normal routine right after.
If you or someone you love has been struggling with depression or treatment-resistant mood disorders, you may have heard about Transcranial Magnetic Stimulation (TMS). Perhaps your provider mentioned it. Maybe you saw it referenced while researching alternatives to antidepressant medications.
Whatever brought you here, one thing is clear. You want to know exactly what a TMS session looks and feels like before you commit. That is a smart and reasonable question, and it deserves a thorough answer.
At Mental Health and Wellness of Southern Utah, our team walks every patient through the process before the first session begins. Understanding what to expect helps reduce anxiety and builds the confidence needed to complete a full treatment course.
What Is TMS Therapy, and Why Does It Matter?
TMS stands for Transcranial Magnetic Stimulation. It is a non-invasive, FDA-cleared brain stimulation therapy. The U.S. Food and Drug Administration approved TMS for major depressive disorder (MDD) in 2008. Since then, it has also received approval for obsessive-compulsive disorder (OCD).
Clinicians use TMS to treat patients who have not responded adequately to antidepressant medications. This group is often described as having treatment-resistant depression (TRD). The therapy works by using a pulsed magnetic field to stimulate underactive nerve cells in the prefrontal cortex, the brain region closely linked to mood.
Think of it this way. When specific neural pathways become sluggish or underactive, mood disorders can take hold. TMS gently stimulates those pathways, encouraging them to function more normally over time.
This approach differs significantly from electroconvulsive therapy (ECT). TMS does not require anesthesia. It does not induce a seizure. Patients stay awake and alert throughout every single session.
Before Your First TMS Session: The Initial Consultation
A TMS course always begins with a thorough clinical evaluation. This step is critical. It helps the treatment team determine whether TMS is appropriate for you and how to calibrate the equipment safely.
During this initial consultation, your provider will typically:
- Review your complete psychiatric and medical history
- Discuss previous treatments, including any antidepressant medications tried
- Screen for contraindications, such as metal implants in or near the head, cochlear implants, or implanted electrical devices
- Ask about any history of seizures or neurological conditions
- Confirm a formal diagnosis of major depressive disorder or another eligible condition
At Mental Health and Wellness of Southern Utah, every TMS patient is evaluated and treated by a dedicated, highly trained provider. This means you see the same person at each session. Continuity of care matters deeply in TMS treatment.
Mapping the Motor Threshold: A Critical First Step
Before your first active treatment session, your provider must determine your motor threshold. This is a personalized measurement. It identifies the minimum magnetic pulse strength needed to produce a small, visible twitch in your hand or fingers.
The motor threshold helps the provider calibrate the machine specifically for your brain. Every person’s threshold is slightly different. Using the correct intensity ensures both safety and effectiveness.
Here is what that process looks like:
- The TMS coil is placed over the area of the motor cortex that controls hand movement.
- Short magnetic pulses are delivered at gradually increasing intensities.
- The provider watches for a subtle finger or thumb twitch.
- Once the threshold is identified, your individualized treatment parameters are set and documented.
This mapping session is usually done on your first treatment day. It takes only a few minutes. The process is clinically important and sets the foundation for your entire treatment plan.
Step-by-Step: What Happens During a Typical TMS Session
Once your motor threshold has been established, your regular treatment sessions follow a predictable and comfortable routine. Here is a step-by-step breakdown of what you can expect.
Step 1: Arrival and Check-In
You arrive at the clinic and check in with the front desk. No special preparation is required before a TMS session. You do not need to fast, don’t need a designated driver, and you can drive yourself to and from appointments.
Step 2: Getting Seated
Your provider brings you to the TMS treatment room. You sit in a reclined, supportive chair, similar to a dental chair. Comfort is a priority throughout the session.
Earplugs or foam ear protection may be provided. TMS devices produce a repetitive clicking or tapping sound during treatment. The ear protection minimizes any acoustic discomfort.
Step 3: Positioning the TMS Coil
Your provider places the TMS coil on your head. The coil is typically positioned over the left dorsolateral prefrontal cortex (DLPFC). This is the area most commonly associated with depression regulation.
The positioning is precise and intentional. Providers use your documented motor threshold coordinates to place the coil correctly at every session. Consistency in placement is essential to the therapy’s effectiveness.
Step 4: Treatment Begins
The TMS device activates and delivers repetitive magnetic pulses in short bursts. You will feel a rhythmic tapping or knocking sensation on your scalp. Some patients describe a light pressure or ticking feeling beneath the coil.
Most people tolerate this sensation quite well. Scalp discomfort, if present, tends to diminish after the first few sessions as your brain and scalp adapt.
You remain fully awake during treatment. Many patients read, listen to music, or simply relax. There is no sedation involved.
Step 5: Session Duration and Monitoring
Standard repetitive TMS (rTMS) sessions typically last between 20 and 40 minutes. Some newer protocols, such as Theta Burst Stimulation (TBS), can deliver treatment in as little as three to five minutes. Your provider will determine which protocol is appropriate for your specific case.
Throughout the session, the provider monitors your comfort, safety, and response. This level of attentiveness is something our team at Mental Health and Wellness of Southern Utah takes seriously.
Step 6: End of Session and Immediate Activities
When the session ends, the coil is removed. You may feel normal. No grogginess, no confusion, and no hangover effect. Most patients get up and head directly to work, school, or other daily activities.
This is one of TMS therapy’s most significant practical advantages. It fits into a busy life without disrupting your daily schedule.
How Many TMS Sessions Will You Need?
A standard TMS treatment course involves daily sessions, five days per week, for approximately four to six weeks. This amounts to roughly 20 to 30 total sessions for most patients.
After completing the initial course, some patients benefit from maintenance TMS sessions. These are periodic booster sessions scheduled weeks or months apart. They help sustain the gains made during the primary treatment phase.
Your provider will work with you to determine the appropriate total number of sessions based on your clinical response and diagnosis. No two treatment plans are identical. At Mental Health and Wellness of Southern Utah, individualized care is central to how TMS is delivered.
What Does TMS Feel Like? Honest Patient Expectations
It is completely normal to wonder about discomfort or side effects before starting TMS. Here is a balanced, evidence-based overview.
Common sensations during TMS:
- A rhythmic tapping or knocking on the scalp
- Light pressure under the coil
- Occasional headache during the first few sessions, which typically fades over time
- Scalp sensitivity or tingling near the treatment site
Less common side effects:
- Facial muscle twitching during stimulation
- Jaw or tooth discomfort in some patients during initial sessions
- Fatigue following early treatments as the brain adjusts
Rare but important to note:
- Seizures have been reported in rare cases, which is why a thorough screening process is conducted before treatment begins
- Patients with certain metal implants, deep brain stimulators, cochlear implants, or implanted electrical devices are typically not candidates for TMS
The overall safety profile of TMS is well established. Clinical studies consistently show it to be tolerable and well-accepted by the vast majority of patients.
TMS and Its Connection to Other Mental Health Conditions
While TMS is most widely recognized as a treatment for major depressive disorder, its clinical applications continue to expand. Understanding this broader picture helps patients and families make informed decisions.
TMS has received FDA clearance for the following conditions:
- Major Depressive Disorder (MDD)
- Treatment-Resistant Depression (TRD)
- Obsessive-Compulsive Disorder (OCD)
TMS is also being studied for the following conditions, with promising but still-evolving evidence:
- Anxiety disorders
- Post-Traumatic Stress Disorder (PTSD)
- Bipolar depression
- Chronic pain syndromes
- Smoking cessation
If you are curious whether TMS might support treatment for a condition not listed here, speaking directly with a qualified psychiatric provider is the best next step. Our team at Mental Health and Wellness of Southern Utah is happy to discuss your specific situation.
How TMS Compares to Medication Management
Many patients who pursue TMS have already tried one or more antidepressant medications without adequate relief. This is understandable. Medications work well for many people, but they are not effective for everyone.
Medication management and TMS are not competing approaches. They can often be used together. Some patients continue taking antidepressants while receiving TMS. Others use TMS as an alternative when medications have caused intolerable side effects.
Here is a practical comparison:
| Feature | Antidepressant Medication | TMS Therapy |
|---|---|---|
| Mechanism | Systemic neurochemical adjustment | Targeted brain region stimulation |
| Requires anesthesia | No | No |
| Systemic side effects | Common | Rare |
| Time to results | Weeks to months | Often within 2 to 4 weeks of treatment |
| FDA approval for depression | Yes | Yes |
| Non-invasive | Yes | Yes |
Neither approach is superior in every case. The right path depends on the individual patient’s clinical history, preferences, and response to prior treatments.
What Makes TMS at Mental Health and Wellness of Southern Utah Different?
Not all TMS programs are created equal. Many clinics rely on technicians to administer TMS sessions with minimal oversight. At Mental Health and Wellness of Southern Utah, every TMS session is personally overseen by Trevor Gee, APRN, PMHNP-BC, our dedicated TMS provider.
Trevor Gee is not just a clinician who performs TMS. He is a patient who experienced TMS firsthand after more than two decades of battling treatment-resistant depression. His personal recovery through TMS therapy inspired him to become a psychiatric provider and bring this treatment to others in Southern Utah.
This kind of dedication shapes the entire patient experience. Choosing a provider who understands TMS from the inside out is a meaningful advantage.
Patients at our clinic benefit from:
- A consistent, experienced TMS provider at every session
- Personalized stimulation parameters tailored to each individual
- A thorough screening process to ensure candidacy and safety
- Ongoing monitoring and communication throughout the full treatment course
- Warm, supportive care in a comfortable clinical environment
Our locations in St. George and Cedar City make expert TMS therapy accessible throughout Southern Utah.
Frequently Asked Questions About TMS Sessions
What should I do to prepare for a TMS session?
No special preparation is required. You can eat normally, take your regular medications, and drive yourself to and from appointments. Avoid wearing jewelry or metal hair accessories near the treatment site. If you have questions about any medications you are currently taking, speak with your provider beforehand.
Does TMS hurt?
Most patients describe TMS as mildly uncomfortable rather than painful. The tapping sensation is noticeable but manageable. Scalp tenderness during the first few sessions is common. This discomfort typically decreases as treatment continues. If you experience significant pain during a session, tell your provider immediately so adjustments can be made.
Can I work or drive after a TMS session?
Yes. TMS does not cause sedation or cognitive impairment. The large majority of patients drive themselves and return to their regular activities right after treatment. This is one of the key advantages TMS holds over treatments that require sedation or recovery time.
How soon will I notice results from TMS?
Many patients begin noticing improvements in mood, sleep, and energy within two to four weeks of starting treatment. Others experience changes closer to the end of the full treatment course. Clinical response varies from person to person. Completing the full prescribed course of sessions gives patients the best chance of a meaningful response.
Is TMS covered by insurance?
TMS therapy for major depressive disorder is covered by many major insurance plans, including Medicare and Medicaid, when medical criteria are met. Coverage for other conditions may vary. Our team can help you verify your specific insurance benefits before starting treatment. Contact us at Mental Health and Wellness of Southern Utah for assistance with insurance questions.
Who is not a good candidate for TMS?
Certain medical factors may disqualify someone from receiving TMS. These include having metal implants in or near the head, a cochlear implant, a vagal nerve stimulator, deep brain stimulators, or a personal history of seizures or epilepsy. A comprehensive intake evaluation will help determine whether TMS is safe for your specific situation.
Can TMS be combined with therapy or other treatments?
Absolutely. TMS is often used alongside psychotherapy, counseling, and medication management. A comprehensive, integrated treatment plan frequently produces the most lasting results. Your provider can help coordinate care across multiple treatment modalities.
What happens after the TMS course is completed?
After completing your initial treatment course, your provider will evaluate your clinical response. Some patients achieve lasting remission without further treatment. Others benefit from scheduled maintenance sessions every few months. Your provider will recommend a follow-up plan based on your individual progress and long-term goals.
Ready to Take the Next Step?
TMS therapy offers meaningful hope for people who have struggled with depression and have not found relief through traditional treatments. It is safe, non-invasive, and backed by strong clinical evidence. Sessions fit into a daily schedule without disruption, and no anesthesia or recovery time is required.
If you are ready to find out whether TMS is right for you, our team is here to help. Visit our TMS Therapy page to learn more about what we offer. You can also explore our FAQ page for additional information or contact us directly to schedule a consultation.
Living a happier and healthier life is within your reach. Let us walk that path with you.
This content is intended for informational purposes only. It does not constitute medical advice, diagnosis, or treatment. Always consult a qualified mental health provider or physician to determine whether TMS therapy is appropriate for your specific situation.
